中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (20): 3722-3725.doi: 10.3969/j.issn.1673-8225.2010.20.026

• 组织构建细胞学实验 cytology experiments in tissue construction • 上一篇    下一篇

心肌桥壁冠状动脉内皮细胞超微结构及血流动力学变化

李文华1，刘晓丽1，蔡 平2     

  1. 1西藏民族学院医学系，陕西省咸阳市  712082；
    2铁二十局医院心内科，陕西省咸阳市     712000
  • 出版日期:2010-05-14 发布日期:2010-05-14
  • 作者简介:李文华，女，1964年生，山西省大同市人，汉族，1987年西安交通大学医学院毕业, 副教授，主要从事医学细胞与遗传研究。 xzmylwh@163.com

Ultrastructure and hemodynamic changes of endothelial cells from myocardial bridge mural coronary artery

Li Wen-hua1, Liu Xiao-li1, Cai Ping2   

  1. 1Department of Medical Sciences, Tibet Nationalities Institute, Xianyang   712082, Shaanxi Province, China;
    2Department of Cardiology, Railway 20 Bureau Hospital, Xianyang   712000, Shaanxi Province, China
  • Online:2010-05-14 Published:2010-05-14
  • About author:Li Wen-hua, Associate professor, Department of Medical Science, Tibet Nationalities Institute, Xianyang 712082, Shaanxi Province, China xzmylwh@163.com

PDF

533

被引次数

36

摘要：

背景：国内外已有较多研究从组织学角度观察心肌桥对心肌血流灌注和动脉硬化的影响，但较少见有关心肌桥作用下壁冠状动脉及其近段、远段血管内皮细胞的超微结构特征的研究。
目的：观察心肌桥壁冠状动脉及其近段内皮细胞超微结构特征以及心肌桥导致的血流动力学变化。
方法：用肝素-生理盐水和4%戊二醛溶液常规处理10例心肌桥冠脉搭桥术患者切除的左冠状动脉，取壁冠状动脉近段、壁冠状动脉段、壁冠状动脉远段，扫描电镜观察其血管内皮细胞和基膜特征。
结果与结论：10例标本心肌桥存在位于前降支中段和近段行程中，长度为2.4~3.6 mm。壁冠状动脉近段内皮细胞多呈卵圆形，长轴和血流方向一致，细胞表面可见到许多“虫啄样”缺损。壁冠状动脉段内皮细胞细长，呈梭形，长轴和血流方向一致，细胞较少脱落，2例标本在内皮细胞表面见到微绒毛，并可见有特殊的桥样结构，该结构常始于细胞的一端，在管腔内游离一段后再与相邻的细胞形成连接。壁冠状动脉远段内皮细胞形态较不规则，表面有少量“虫啄样”破坏，边缘境界清楚，很少脱落。壁冠状动脉段内皮细胞与近段、远段内皮细胞相比，面积基本相同，但周长明显增加，形态指数显著较低(P < 0.05)。提示 壁冠状动脉内皮细胞受到心肌桥压迫导致血流切变力增高产生适应性反应，对内皮细胞有保护作用，而其近段内皮细胞由于切变力较低容易被损伤,成为动脉粥样硬化发生的基础。

关键词: 心肌桥, 血管内皮细胞, 扫描电镜, 冠状动脉硬化, 心肺组织工程

Abstract:

BACKGROUND: Numerous studies have observed effects of myocardial bridge on myocardial blood flow perfusion and arteriosclerosis from the angle of histology. However, there were few studies concerning ultrastructure characteristics of coronary artery and proximal and distal vascular endothelial cells with the influence of myocardial bridge.

OBJECTIVE: To observe myocardial bridge mural coronary artery and proximal endothelial cell ultrastructure characteristics and myocardial bridge-induced hemodynamic changes.

METHODS: Left coronary artery, mural coronary artery proximal end, mural coronary artery and mural coronary artery distal end of 10 patients with coronary artery bypass grafting were treated with heparin-saline and 4% glutaral. The characteristics of vascular endothelial cells and basal lamina were observed with a scanning electron microscope.

RESULTS AND CONCLUSION: Myocardial bridges of 10 samples located in the middle and proximal anterior descending branch, 2.4-3.6 mm in length. Mural coronary artery proximal portion endothelial cells presented orbicular-ovate. Long axis showed the same direction as blood flow. Many defects were seen on cell surface. Mural coronary artery endothelial cells were long, spindle-shaped, with the consistent direction of long axis and blood flow. Few cells dropped out. Microvillus was observed on endothelial cell surface of two samples, with special bridge-like structure, which was commonly found in one end of cells and connected with consecutive cells following liberation in the lumens. Endothelial cells from mural coronary artery distal end were irregular, with a few detects on the surface, clear boundary, no drop out. Endothelial cells from mural coronary artery had similar area as endothelial cells from the proximal and distal ends. However, perimeter was significantly increased, but morphous index was significantly low (P < 0.05). These indicated that endothelial cells of the mural coronary artery are free from atherosclerosis due to higher shear stress caused by myocardial bridge. The intima of the section proximal to mural coronary artery was likely to be sclerosed due to the lower and oscillatory shear force.

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